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Rehab Measures: Baseline Dyspnea Index

Link to instrument

Link to Baseline Dyspnea Index 

Title of Assessment

Baseline Dyspnea Index 


Instrument Reviewer(s)

Initially reviewed by Kavita Joshi, PT, MS in 10/2013.

Summary Date



Rating severity of dyspnea at a single point in time


  • A 24 item interviewer administered rating of severity of dyspnea at a single state
  • There are 3 categories and 24 items in the instrument- Functional impairment: Functional loss is evaluated during occupational activities/daily living , Magnitude of task: It assess what daily living tasks can provoke dyspnea, Magnitude of effort: It evaluates how much effort needs to be sustained by the individual to evoke dyspnea
  • Each category has 5 levels of symptom severity 0-4.
  • Patient’s condition is rated from 0 (severe) to 4 (unimpaired) for each category
  • Ratings on each of the three categories are added to get a score ranging from 0-12
  • Each category has 3 circumstances in which dyspnea can’t be measured - Amount uncertain, Unknown, Impaired for reasons other than shortness of breath
  • Lower score indicates greater severity of dyspnea

Area of Assessment


Body Part


ICF Domain




Assessment Type


Length of Test

05 Minutes or Less 

Time to Administer

Number of Items


Equipment Required

Computerized version needs a computer otherwise no equipment are needed.

Training Required


Type of training required

No Training 



Actual Cost


Age Range


Administration Mode




Populations Tested

  • COPD

Standard Error of Measurement (SEM)

Not Established

Minimal Detectable Change (MDC)

Not Established

Minimally Clinically Important Difference (MCID)

Not Established

Cut-Off Scores

Not Established

Normative Data

Not Established

Test-retest Reliability


(Mahler, Ward, Waterman et al, 2009; n = 101; mean age = 66 (9) years)

  • Excellent test retest reliability (ICC = 0.90)

Obstructive Lung Disease:

(Eakin, Sassi-Dambron, Ries et al, 1995; n = 143; mean age = 67.7 (8.6) years)

  • Excellent test retest reliability (ICC = 0.76)

Interrater/Intrarater Reliability

Chronic Obstructive Pulmonary Disease:

(Meek, Lareau, 2003)

  • Adequate interrater reliability (ICC = 0.65 - 0.72)

Obstructive Lung Disease:

(Eakin, Sassi-Dambron, Ries et al, 1995)

  • Excellent interrater reliability (ICC = 0.88)

Internal Consistency

Obstructive Lung Disease:

(Eakin, Sassi-Dambron, Ries et al, 1995)

  • Excellent internal consistency (Cronbach’s alpha = 0.80); 6 measures of dyspnea were reviewed

Criterion Validity (Predictive/Concurrent)


(Mahler, Waterman, Ward et al, 2007; n = 65; mean age = 67 (9) years)

  • Adequate correlations between SAC BDI and MRC scale (r = -0.56)
  • Excellent correlations between interview BDI and MRC scale (r = -0.73)

(Witek, Mahler, 2003; n = 997; mean age = 64 years)

  • Adequate to excellent correlations with SGRQ scores (r = -0.35 to -0.64)
  • Adequate correlations with DD score (r = -0.34)
  • Adequate correlations with PGE at baseline (r = 0.39)

Construct Validity (Convergent/Discriminant)


(Witek, Mahler et al, 2003)

Obstructive Lung Disease:

  • (Eakin, Sassi-Dambron, Ries et al, 1995)
    • Adequate correlation with SOBQ (r = -0.70)

Content Validity

Not Established

Face Validity

Not Established

Floor/Ceiling Effects

Not Established


Not Established

Professional Association Recommendations


  • BDI has been used on large populations and for different cardiorespiratory conditions
  • BDI also has a self administered computerized version
  • Its optimal use depends on the clinical experience of the raters
  • Ratings by non physician personnel may be more accurate than those by the physicians, since they may be less likely to be affected by the expectations of a physician’s response to therapy
  • Few instructions are provided with the instrument


Eakin, E. G., Sassi-Dambron, D. E., et al. (1995). "Reliability and validity of dyspnea measures in patients with obstructive lung disease." Int J Behav Med 2(2): 118-134. Find it on PubMed

Mahler, D. A., Ward, J., et al. (2009). "Patient-reported dyspnea in COPD reliability and association with stage of

Mahler, D. A., Waterman, L. A., et al. (2007). "Validity and responsiveness of the self-administered computerized versions of the baseline and transition dyspnea indexes." Chest 132(4): 1283-1290. Find it on PubMed

Mahler, D. A., Weinberg, D. H., et al. (1984). "The measurement of dyspnea. Contents, interobserver agreement, and physiologic correlates of two new clinical indexes." Chest 85(6): 751-758. Find it on PubMed

Meek, P. M. and Lareau, S. C. (2003). "Critical outcomes in pulmonary rehabilitation: assessment and evaluation of dyspnea and fatigue." J Rehabil Res Dev 40(5 Suppl 2): 13-24. Find it on PubMed

Witek, T. J., Jr. and Mahler, D. A. (2003). "Minimal important difference of the transition dyspnoea index in a multinational clinical trial." Eur Respir J 21(2): 267-272. Find it on PubMed

Year published


Instrument in PDF Format

Approval Status Approved 
Created at 2/5/2014 3:19 PM  by Jason Raad 
Last modified at 6/6/2014 12:15 PM  by Jason Raad